6 Things Everyone Should Know about Anxiety – Anxiety Workshop with Nick Wignall

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I did an anxiety workshop with my friend and colleague Nick Wignall, psychologist and writer at We Take a deep dive into the 6 things we wish everyone knew about anxiety and then answer viewer questions. 

Welcome to the Anxiety Workshop

Nick: Well, welcome everyone. Thank you so much for coming. We’re excited to be here and talk about setting boundaries on your bossy anxiety, cuz anxiety has a tendency to get very, very bossy. Credit to Emma for that …. that title suggestion. I loved it. We had a much more generic sounding title until you came up with that one.

Emma: Yeah, I’ve been thinking a lot about how anxiety bosses people around. So ….

Nick: Yeah. Well, let’s do …. let’s do a quick intro. Emma, do you wanna introduce yourself real quick?

Emma: Sure. I’m Emma McAdam. I’m a licensed marriage and family therapist. I have a YouTube channel called Therapy in a Nutshell, and that’s where I teach a lot of skills around mental health. So the focus of that channel is just like, here’s what you can do to learn more skills and add more tools to your toolbox to manage, you know, anxiety, depression, PTSD specifically, and then mental health in general.

Nick: Awesome. Yeah. And I’m Nick Wignall. I’m a clinical psychologist. I practice for six or seven years doing individual therapy with folks with, mostly with anxiety, a little bit of insomnia too. And on the side I started a …. a blog in a newsletter, kind of in a very similar vein to Emma on emotional health and wellbeing and just trying to share a lot of the ideas and tips and tools that we have in the therapist office that really are applicable to all of us. And specifically I think we’re gonna talk about some of our more underrated tips for dealing with anxiety. And so real quick, the structure of what we’re gonna do is we’re gonna spend about a half an hour Emma and I are gonna go back and forth swapping some of our …. our favorite tips and we’ll spend about five minutes each on, we’ve got three tips each. And so we’ll go through those and then in the back half we’ll open it up for questions and go deeper or answer other questions that We don’t get to in our answers. So, I think that’s about it. All right. Well, let’s do it. Emma, what is your first tip or suggestion when it comes to dealing with anxiety?

1. Clarify Stress, Anxiety, and Worry as Mind-Body Aspects of Anxiety.

Emma: Yeah. So, the first thing I would wanna say is that a lot of times we use the terms stress, anxiety, and worry all just interchangeably. Like, oh, I had this big test. I was so worried about it. It made my stomach hurt or I was so stressed out about it that it made me anxious or whatever. Right? We use these terms interchangeably and if we can get more clarity on those terms, it actually gives us more tools to know what to to do with them. So, I just wanna clarify terms for a second. So stress is actually what’s going on in your body. Stress is the physiological response to a perceived danger. Whether it’s a real danger or just something you think might be dangerous, your body’s gonna kick off that fight, flight, freeze response. Pump out cortisol. Pump out adrenaline. Change your breathing. Change your heart rate. Make your hands sweat more. All these things to avoid a physical threat and that’s what stress is. Now, I often tell the story of how I used to work in wilderness therapy with teenagers and we’d hike a lot. We spent, I spent over a year and a half of my life living outside. And one day I was out hiking in the mountains of Utah and I step over this rock that had a gap, like a four-inch crack in it. And I hear this sound. And before I had even realized it, I had jumped like three feet. So my limbic system responses fight, flight, freeze response had activated just super fast before my brain had even caught up. I jumped three feet. So that’s the stress response, right? That is the nervous system activation, that’s the physical side of anxiety. Now, the other side of anxiety Is worry, which is the thinking aspect of anxiety. So our thoughts directly contribute to how we think and feel because we use our super powerful brains to imagine all kinds of danger. And that’s really what separates humans from other animals is our ability to conceptualize, to imagine, to think up dangers that could happen in a week, in a month, in a year, and to plan around that and prepare for that because We needed our big brains to survive out on the Savannah or whatever cuz we don’t have very good claws, right? We don’t have very big teeth. We had to mentally plan how to catch our animals and avoid getting eaten by other ones. So that’s the other aspect of anxiety. There’s the thoughts and there’s so worry is the thoughts about anxiety, the cognitions that happen in the upper part of our brain and stress is what’s going on physiologically. And I, my definition of anxiety is that it’s usually the combination of those two things. Would you agree with that, Nick? Is that how you define anxiety?

Nick: I was gonna ask you about this. It’s very interesting cuz I do the same thing. I think making these distinctions is really helpful. And we all tend to get a little sloppy with words here. Especially when we’re feeling really anxious. I think the, yeah the mental part of it is definitely a discreet thing. So our thinking, our worries. Right? And then there’s the physiological distress and I think it’s useful to think of the emotional part as like a third its own thing, like feeling anxiety or panicky. Like it’s sort of, usually it’s a combination of having worried thoughts often about how we’re feeling physically. Yeah. Right? And it …. it creates what we call an emotion, which is sort of a combination. It’s like a mashup of thoughts and physical sensations and perceptions. And so technically speaking, is it, is it its own category? I don’t know, but I think it’s helpful to divide up. Like I’m feeling anxious. That’s the emotional level. I’m worrying that’s the mental or cognitive level. And I’m feeling stressed out in my body. Right? My heart rate’s up my, I feel like tingly in my extremities, all that stuff that goes along. So, I think those three categories are really a helpful way to, like you were saying, make these distinctions and get some clarity about what’s actually going on.

Emma: Yeah …. yeah. And Dan Siegel calls it, name it to tame it, or there’s like the term emotional granularity, which is the …. the more you can like really get concrete and solid about what’s going on for you, the more options you have to treat it. And I …. I like how you use the word emotion. That’s what anxiety is. It’s an emotion. And the cool thing about emotions is that like the Latin root of that word is motion. It motivates us to take some action. So emotions serve a function, they’re there to keep us safe, but when we have an unhealthy relationship with them, they can get really bossy and control our lives in a way that like, leads us to acting in ways that don’t line up with the kind of life we wanna be living. So, as we talk about anxiety and stuff, the first thing I would say is there’s …. there’s kind of two approaches to addressing anxiety. And one of the things I love about Nick is he’s got such a strong cognitive approach. Like I learn so much from him and his newsletter, I read his newsletter every week, and that’s probably the only newsletter I do read every week. Because he’s got such a great cognitive approach. He …. he’s good with the thoughts work. And one of the emphasis …. one of the emphases, well one of the emphasises of my work is the body-based approach. And this is especially powerful with like PTSD, but it really works well with anxiety to notice what’s going on inside of your body and to learn to calm down your body because your brain and body are in a feedback loop. So, when your body is tense and tight, it sends messages to your brain to be alert, activated, and it’s like sometimes that’s called like a gut sense or an intuition, but our brain is constantly scanning our body for signs of peace or anxiety. So one of the ways we can really also send the message to our brain to be calm and to be more relaxed is to physically change the state of your body. So that’s called a bottom-up approach. So, doing cognitive work is called a top-down approach where you change how you think and how you perceive your situations and your thoughts. And a bottom-up approach is creating shifts inside of your body. So, some of the most basic approaches that a lot of people have heard of is like deep breathing. So if you go right now and you just slow your breathing down to a slow out breath, when you breathe in, try not to breathe with your shoulders so much, but let your stomach poke out when you breathe. And like slower out breaths that can send a message to your brain to calm down. And there’s a lot of other skills you can use to calm your body down. Some of the most common are of course, deep breathing, progressive muscle relaxation. And then kind of the emerging work from the polyvagal theory are these approaches that trigger the vagus nerve and the vagus nerve, you know, contributes to that feedback loop. It sends messages in both directions in your body and it helps regulate your nervous system response. So, daily self-regulation, like if you can catch yourself a couple times every day or more, just check in with yourself. Say, where’s my body at? Am I feeling tense? Am I feeling anxious? Am I feeling worried? And then just use a moment to like, regulate your nervous system by some of these exercises that can really help. I just wanna teach one other really quick vagus nerve exercise before we move on to the next segment. And so that’s the yawn. So if you do a big fake yawn right now, it can be kind of contagious. You might start yawning naturally, and that triggers the vagus nerve, actually exits your brainstem near the top of the roof of your mouth, and it can trigger that vagus nerve to send calming messages to your brain. So, there you go. There’s a couple bottom-up approaches to anxiety. I already feel a little bit better after, like, slowing myself down.

2. Learn The Difference Between A Worry And Worrying

Nick: Yeah, I …. I always get a little nervous before these kind of talks, you know, my muscles get a little twitchy and my heart rate goes up and I like the yawn though. The vagus nerve stuff is cool and I’ve been learning about that stuff from you more. I didn’t have much training in it, so. And I really like your distinction between kind of top-down and bottom-up approaches. I think is really just a helpful frame. But speaking of top-down approaches my first tip, which I think fits in the top-down category, is to accept your worries and control your worrying. So, I’m gonna make a distinction here, just like Emma made a distinction. I think it’s really useful to distinguish a worry. From worrying. Now the distinction is, if I said …. if I said, okay, everybody pay really close attention to what I’m gonna say next. Pink penguins. Okay? Now you probably had thoughts or images of pink penguins come into your head right after I said that. You didn’t decide to think about pink penguins. I said something and your mind reacted through no control over yours to that …. to that stimulus that I put out there. Right? So that’s what we call an intrusive or unintended thought, right? And worries can be unintended, worries can just pop into our mind. And we don’t have any control over that. Okay? So that’s when I say a worry, that’s a worry. It’s something that’s unintended. Now worrying though is something you do have control over. So we also have controllable thoughts. So if I said in your mind, multiply 13 times four. Some of you probably know that is automatically, but if you picture like a one and a three and a four and you multiply the four times, the three first, right? And then you do the four times, that you’re controlling your thoughts, right? You are deliberately controlling how you’re thinking, right? So when it comes to worry, some types of worry, like a worry popping into your mind, it’s not under your control, right? It’s not something you should put pressure on yourself to be able to control. Oh, I shouldn’t worry so much, right? You can’t control whether a worry pops into your mind. However, you can control whether you continue to elaborate on or keep worrying about that worry, right? So to make this kind of concrete, imagine you’re at a meeting at work, right? And you …. you have a great idea. You think, Ooh, I’m gonna share this idea with the group. But then a worry pops in your mind like, oh, what if they hate it? Now you didn’t control that. You didn’t decide to have a worry. Right? But what you do next is critical. Do you continue to elaborate on that worry? You know, you go, oh, like my boss is gonna think it’s dumb. And you know, if she thinks it’s dumb, like I don’t know, I’m gonna stop. I won’t get that promotion. And then what if I lose my job entirely? I’m like, how am I gonna pay the rent? And like, we all know that spiral of worrying, right? What’s key to see is while you couldn’t control that initial worry, you can control whether you continue to elaborate on all those worries. And every time you worry, you’re adding more and more anxiety to your overall system. So in your head, having this distinction between a worry, which you should not feel pressure to be able to do anything about, cuz it’s just inevitable, right? That’s very different than worrying, which is a habitual behavior, a mental behavior that you can actually control if you become more aware of it and practice doing it. Okay, so that’s my …. that’s my first tip is to distinguish a worry from worrying. And don’t spend time dumping time and energy into trying to control worries that pop into your head. You …. you will fail. You can’t do it. Instead, use that energy to take control over your worrying, right? To let that go. To let your, accept the worry, right? And control your worrying, right? Redirect your mind onto something else that’s more productive. And it’s difficult, but you can do it, especially if you can get better at distinguishing a worry, which is uncontrollable from worrying, which is actually a behavior that you can control. That’s my tip, tip number one.

Emma: I love it. And I think I …. I might, I dunno if I’ve told you, Nick, I took your course and it was like super helpful for me. Like me personally.

Nick: Oh, cool.

Emma: Yeah, yeah. Like I hadn’t …. I hadn’t had worry explained to me as clearly as that. Nick has a course on worry, in case you guys didn’t know. And it’s just really good. Like, I think my anxiety probably decreased by like 25 to 50% by like understanding like worry better. And I teach a lot about anxiety. So, I’m a believer.

3. Stop Resisting Or Avoiding Anxiety

Nick: Awesome, awesome.

Emma: Yeah.

Nick: So let’s go to tip number two.

Emma: Let’s go to tip number two.

Nick: What do you got, Emma?

Emma: Okay. So I think when it comes to anxiety, and I’m gonna just take it back a little bit. The first thing about anxiety is a lot of times it’s uncomfortable. People don’t like how anxiety feels. People don’t like how worry feels, and they don’t like the physical sensations of anxiety, like the upset stomach or whatever. So our instinctual reaction is to avoid things that make us feel anxious. And sometimes that works, like in the case of a rattlesnake, absolutely beneficial, jump away from that rattlesnake, right? With physical threats, it’s pretty …. pretty effective tool is to like, let’s just stay away from big, steep cliffs and rattlesnakes and stuff. But when it comes to the problems we face day-to-day in life, avoidance can lead to a really big trap. And that’s because of that’s how the brain works. So, when we perceive something as dangerous, let’s say you’re afraid of dogs and you see a dog in the street walking toward you, it’s on a leash and it might be a 12-inch Pomeranian, you know, but whatever. And you feel nervous and you avoid that dog, then you don’t die afterwards. Your brain is like, whew, I felt nervous. I avoided that situation and I didn’t die. Avoiding that situation must have been what kept me alive. So, I’m gonna make my human repeat that behavior by increasing their anxiety level around dogs so that they’re more like to avoid that situation again. There’s another example of this where researchers studied this …. this group of like eighth graders who were studying to or practicing to audition for a play, and they wanted a part in this play, but they were nervous about us. They asked all these kids, you know, what’s your anxiety level? And a bunch of them said, oh, I’m like a seven. I’m at an eight. I’m at a nine in …. in nervousness. And then after the audition, some of the kids chose to audition and some of them didn’t. And they …. they interviewed the kids again. Well, why did you choose to audition when you were so nervous about it? And the group of kids who did choose to audition said, well, I cared so much about being in the play. That was the only way to get in the play. I had to audition to get in the play. So, I chose to do it. And then the other group of kids said, “The only way to make my anxiety go away was to not audition for the play.” it’s two different motivations, right? The one group was motivated to avoid their feelings and the other group was motivated to act on the kind of life they wanted. And a lot of us get caught in this trap where when we feel anxious, we wanna avoid the things that make us feel anxious. So whether that’s breaking up in a relationship that you’re feeling uncertain about, or whether that’s doing like OCD behaviors, compulsive behaviors around a worry about like, oh, did I leave the house unlocked? And then you check the house over and over again in an attempt to avoid that anxiety. That is what maintains one aspect of some, the behavioral aspect that maintains the anxiety cycle. It makes us more anxious. And if you look at those two groups of kids with who auditioned the …. the group who auditioned in the group who didn’t, which one the next time auditions come up, which group is gonna feel more anxious about those auditions? It’s gonna be the one who didn’t audition the first time and the ones who did audition, they might still feel anxiety, but it’ll either probably be a similar or a slightly less. So, one, one of the big keys with anxiety is learning to really distinguish between actual danger and perceived danger. So, a rattlesnake actual danger and audition, perceived danger. And then choosing not to get stuck in chronic avoidance of things that make you anxious cuz that is, from my perspective, one of the biggest things that increases our anxiety levels. So, choosing instead to make your focus on what kind of life do you wanna live, and then accepting and being open to the feelings you have while you face those …. those fears on a behavioral level. Like you just make yourself, like go do the scary thing and your anxiety will most likely decrease. So that eventually …. eventually …. eventually, usually, eventually, and even if it doesn’t decrease, you’re still living a life that you value instead of living a life where you’ve shrunk.

Understanding How Small Forms Of Avoidance Contribute To Anxiety

Nick: So, yeah.

Emma: Oh, , I got one more thing to say about that and that is a lot of times we get stuck in these very small forms of avoidance. And it’s super easy as soon as you have one of these things in your hand. Yeah, you feel a little bit anxious. You’re like, I’m gonna look at TikTok. You feel a little bit anxious. I’m gonna check my email. I feel a little bit anxious. I’m gonna watch YouTube. I’m gonna do whatever. And that this is like I, in my mind, it’s not like what’s on the phone necessarily that’s making people anxious though, like the news and Instagram can, but it’s this habit of when I feel anxious at a party, I’m gonna look at my phone instead of engaging with people. When I feel anxious at work or when I feel anxious about like, applying for this job, I’m gonna go watch 20 hours of Netflix instead. And that’s increasing people’s anxiety. Okay. You were saying something and I interrupted you.

Nick: No, I love, I think that’s a great example cuz so much of it comes from those, it’s like death by a thousand pin pricks, right? It’s those tiny little bits of avoidance, which as you, one of the ways I like to think about what exactly what you’re saying is that our kind, your anxiety is there for a reason, right?

Emma: Yeah.

Nick: And …. and it’s to keep you safe from threats. And so part of our job is to make sure our anxiety system is well calibrated, that it can detect a true threat from a false threat. Right? And the, what’s crazy, what …. what’s really wild about the human brain is it’s got a built in self-correction mechanism. So it learn, your brain learns about what’s dangerous based on your own behavior. Right? So, when you, like you were saying, I mean, when you avoid things, what you’re teaching your brain is that thing is literally dangerous.

Emma: That’s

Nick: It’s life threatening, right? Whereas when you approach things or are willing to have them and get on with your life anyway, you teach, it’s called safety learning, right? You teach your brain that that thing that feels scary isn’t actually scary. So, you’re keeping your …. your threat detection system well calibrated as opposed to when you avoid everything that feels anxious. Pretty soon your brain starts to think everything is anxious, which leads to this chronic …. chronic anxiety, which is what’s so tough to live with.

Emma: That’s right. Yep. Ooh, I like that. So, I wanna hear more about that, but we’ll have, probably have to save that for another day on how to keep your …. your threat assessment system well-tuned.

4. Schedule Your Worry, Set Boundaries On It

Nick: Well tuned, right? That’s right.

Emma: Love it.

Nick: Well, yeah, maybe we can get more into it. But I’m gonna jump to, I’m gonna stick with worry. Actually my …. my second tip is gonna go back to worry because worry is such a, it’s the most direct cause of anxiety. There’s all sorts of things that predispose us to anxiety and can make us more vulnerable to feeling anxious. You can’t actually have the emotion of anxiety without the, you can have a reflex, you can have a stress response. But you don’t get anxiety without some form of worry. And so that’s why I, I’m …. I’m really big on thinking about worry and focusing on worry, but, and one of the, arguably the most powerful practice I know for lowering chronic worry in the long term, which has the direct result of lowering chronic anxiety, is a technique called scheduled worry, which basically involves the very counterintuitive practice of scheduling time to worry on purpose at the same time every single day. This one’s really weird, and I, I start this one off with the example of suppose you get a new puppy, right? Brand new puppy, two days old, right? Puppies don’t, aren’t born potty trained. They, if you just let ’em do their thing, they will, they will be pooping all over the place, right, on your couch, on your deck, on your lawn, all over the place, right? But you can’t just tell your puppy not to poop on the couch. Right? You sit there and explain it in very rational terms. Hey, little puppy, like, you really shouldn’t do this cause it makes a mess. It’s not gonna know what you’re saying. Right? On the other hand, so how do you get, how do you house break a dog, right, a new puppy? Well, the …. the kind of ironic thing is you can’t actually teach it where not to do its business. What you do is you teach it the right place to do its business. And if it gets really, it learns really well that, hey, there’s one spot that little dirt patch out in the backyard where I’m supposed to do my business, it learns by extension not to do its business and all the other places near the yard. Now, this is a goofy analogy, but it works really well for …. for worry and anxiety because when your …. when your worry is out of control, it’s coming out all over the place all times and days, right in the middle of the night while you’re on your way to work, while you’re reading your kids’ bedtime stories, like whatever. It’s just showing up everywhere and it’s keeping us really stressed out and anxious. So, one of the best ways to reduce kind of chronic worry and therefore chronic anxiety, is to train your brain to worry during a very discreet period of time. And that’s what scheduled worry is. So you literally, you pick a 10 minute period of time that you can commit to every day. I like to do it in the early evening, like after I put my kids down to bed, but not right before bed. That’s usually not a great time to do it. And you sit down, you set a timer for 10 minutes, you get a piece of paper and a pencil or pen, and you just start listing every worry you can think of. You say, brain, all right, like, open up the fire hose, give it, gimme all the worries you got. Right? Everything from you forgot to get bananas at the grocery store to nuclear holocaust. Like, tiny, big, realistic, unrealistic, whatever. You just get all your worries out onto paper, write ’em down, transcribe ’em. You’re not solving your worries. You’re literally just listing them all down on paper. And what this is doing is when you deliberately give attention to your worries, you’re reinforcing them. So you’re training your worry brain, hey, this is the time for worry. This is when you do it. And when it really learns that it has this effect of lowering your worries, become less intrusive throughout the rest of the day, which lowers your overall baseline level of anxiety. So it’s …. it’s really, it sounds really counterintuitive, but making a little bit of time every single time, every single day to worry on purpose and on paper, that’s critical. You gotta do it on paper. And we can get into why that’s important. It’s so powerful. I’ve, when …. when people actually do this, I’ve been recommending this for years, when people actually do this, it’s transformative. The degree to which it lowers your worry and therefore your anxiety levels. So, it’s a really simple practice. There’s more, I actually have a little, I created a tiny little mini website just for this. I’ll throw it in the chat right now that’s got instructions on how to do this. But it’s basically just sit down and like, list your worries out on paper and it’s …. it’s so powerful for reducing chronic worry and lowering your overall anxiety level. So, that’s my tip number two is making time to worry on purpose. Very counterintuitive, but very helpful.

Emma: I love it. I love it. And I said, when I took your course, like it was transformative. And Nick and I did not have an agreement for me to like plug his course. Like, that is not the goal of this webinar.

5. Take Physical Action To Create Safety, Set Boundaries, Take Action

Nick: I slipped her a 20 before the, before she hopped on. Yeah.

Emma: But like, actually, yeah, and getting it, making it really concrete is super helpful. And …. and that takes me to my …. my next point, which is like boundaries and assertiveness and …. and we’re talking about boundaries with worry. So worry likes to be bossy. Right? Our brain is more attuned to threats. It’s more likely to notice one bad thing than it is to notice a hundred like mildly positive things. And so in that way, anxiety and fears can be very bossy. They’re very loud in our brains. And one of the things that I’ve noticed that anxious people do a lot is when they feel anxious, they try to take a lot of action. They try to do more and keep themselves really busy. For anxious people, they’re a lot less likely to benefit from relaxation skills because they have a really hard time relaxing. It’s uncomfortable for them because they believe they’re in actual threat. And you mentioned, right, like our, it’s important to be able to distinguish between real threats and perceived threats or imagined threats. But anxiety serves a function, right? It’s supposed to be there. So sometimes anxiety, when you have anxiety that’s like not going away, like you try relaxation or you try this or you try that and it’s still there. What’s actually happening is anxiety has a message for you. And it’s gonna keep trying to deliver that message until you receive it. So, I got an email from someone the other day who said, “Hey Emma! I got diagnosed with borderline personality disorder. I got diagnosed with anxiety disorder. I got diagnosed with depression. I got diagnosed with psychosis. And this went off and on for 10 years. And then when I left my abusive spouse, I don’t …. I don’t have any of those diagnoses anymore. I don’t have anxiety anymore. I don’t have borderline personality disorder and that!” . And that’s because the anxiety wasn’t a disorder in that moment, right? Well, maybe it, and maybe she was experiencing an anxiety disorder on paper, but the anxiety was sending a message, you are not safe. You need to change something about your environment to make yourself safe. And that’s kind of an extreme situation, right? Living with an abusive spouse for 10 years, I mean, I wish it was a super extreme situation, is probably more common than, than we would like it to be. But a lot of times anxiety is trying to tell us you are being too busy. Your life is too chaotic. You could try minimizing some things in your life. And anxiety is trying to send a message to us that hey, you feel like you are constantly under threat at work. Maybe you should consider learning some skills to emotionally distance yourself from work or changing your job or just turning off your emails at night or something like that, right? And sometimes the boundaries we need to set around our anxiety are to protect ourselves because anxiety is …. is actually trying to give us a message like, you’re too busy, you’re, you’re too stressed out because your life’s in chaos. Sit down and do your budget. Like, you’re worried about money. Sit down and do your budget, and you might not feel so anxious about it, right? Like sometimes actual action is helpful. So, emotions aren’t just bad things that happen to us. They aren’t just uncomfortable things that we need to make go away. We need to look at them, listen to the message they’re sending and evaluate. Like, is that a real, a real concern or not, right? Like if I’m afraid that everyone’s thinking bad things about me, eh, that’s probably an imagined or perceived threat. Whereas if I’m like, oh my gosh, I’m so stressed out because I’m always checking all of my comments and believing every mean thing everyone says to me. Well, that might be a sign I need to set some boundaries around how I use my time.

Nick: Emma. I I love that one. I mean, I …. I think you could make a case for, this is actually the most important thing either of us have said so far, which is …. which is to not to treat …. to treat your anxiety even though it’s uncomfortable, to treat it as something that’s trying to help. It might not be correct. It might be giving you bad advice. It might be, but it’s not trying to hurt you. Your anxiety is not a threat, right? And so listening to it and thinking, “Hey, maybe it’s trying to help me, maybe it does actually have something worthwhile to say.”

Emma: And this a skill …. this is …. this is a skill that can actually be learned. It sounds like this woo woo, like, oh, just make friends with your emotions. But there’s actually exercises you can practice on a tangible level to learn this skill. And that’s kind of what you’re gonna talk about, right?

Nick: Yeah. I mean, I …. I …. I think so, but …. but it’s worth pausing on the actual theoretical kind of point, right? It’s like saying that you’ve probably heard that phrase, don’t shoot the messenger, right? Just because someone gives you a message that you don’t like, you don’t like the message, but that doesn’t mean the messenger is bad or dangerous, or needs to be gotten rid of, right? Pain is not the problem. Pain is a messenger.

Emma: That’s right.

Nick: Telling you to address something else. And so I think that’s just such a powerful, important idea to kind of wrap our heads around and remind ourselves of.

Emma: Mm-hmm. I think of this sometimes as like a …. like a kid who’s like, mom, mom, mom, mom, mom, mom, mom, mom, mom. And if you’re like, busy and you’re doing something and you’re like trying to ignore it and trying to distract yourself and trying to like do relaxation techniques, it’s like, mom, mom, mom. And if you’re like, what is it? And they’re like, hey, I did this thing, and you’re like, I’m so proud of you. And then your child like, runs off, right? Like they just wanna be addressed. And I feel like sometimes anxiety is like that, just needs to be addressed and acknowledged. And sometimes just writing down your worries, right? That’s an example of that you’re addressing and acknowledging that messenger. And then you’re choosing like, do I, is …. is the house on fire or not? Okay, we’re good. Like, moving on. Right?

6. Embracing Mindfulness as a Training Exercise rather than a Coping Skill for Anxiety.

Nick: A hundred percent. Yep. It really is about changing your relationship with anxiety, not trying to get rid of anxiety.

Emma: Yeah.

Nick: And that leads to, does lead in well I think to my …. my last, my third tip, which is do mindfulness the right way. Now I’m gonna unpack that a little bit. It sounds a little judgy, but I, there’s a lot in here. And actually this tip is not specifically about mindfulness. I’m gonna use mindfulness as the example. But it’s really about how we approach our worry and anxiety. So, everyone’s heard of mindfulness, everyone’s probably heard of mindfulness as a way to deal with your anxiety. But the, but what I hear all the time is like, oh yeah, mindfulness. Like, I tried that a few times. It didn’t really work. Right? So, what, and I …. I think this …. this comes down to a really understandable but critical confusion that people have with …. with mindfulness, but with lots of other quote unquote coping skills that they hear about for dealing with anxiety, whether that’s deep breathing or mindfulness, or progressive muscle relaxation, whatever it is. And that is coping skills are not actually a great solution for anxiety.

Emma: Amen. Hallelujah. Like, yes. Like I hate, please continue.

Nick: Yeah. Well, and we could talk more about it, but I think the crux of it is, it’s not the coping skill itself that’s the problem. It’s when you use a technique like this as a way to get rid of your anxiety. Like, I don’t wanna feel so anxious anymore, so I’m gonna do deep breathing. Or I’m going to do a mindfulness meditation. That sounds good to you cuz it’s gonna make you feel less anxious. But to your brain, what it’s seeing is, oh my, she’s terrified of anxiety. He’s freaked out by this worry, he’s running away, he’s trying to get rid of it.

Emma: Anxiety is super important.

Nick: Or trying to get rid of something. You’re teaching your brain that thing is dangerous. So even if you get some temporary relief from it, the next time that thing comes around, you’re gonna be even more terrified of it. And you can see how this vicious cycle starts to build up. So when your motivation is to immediately avoid or lower your anxiety, what you’re actually doing is making it worse in the long run. Which gets back to your point, Emma, about of why avoidance doesn’t work in the long run for anxiety. And so you have to be really careful with a lot of these, like, solutions and skills and coping strategies that you hear about. If you use them in the moment to just go, oh, I don’t wanna feel so anxious, I’m gonna, I’m gonna meditate for 10 minutes. You might get some initial relief. But the long-term consequence is you’re gonna be more anxious. So when I say do mindfulness the right way, and this applies to other, do deep breathing the right way, do progressive muscle relaxation the right way; when I say the right way, what I mean is do it as an exercise, not as a coping strategy. And an exercise is something you do to get stronger. It’s something that’s uncomfortable in the moment, but you do it repeatedly in order to build up strength in some particular area, right? So if you’re a sprinter in the Olympics, you might do, you might run intervals or wind sprints, right? They tire you out. They feel uncomfortable, but they build muscle. Here’s the thing, a sprinter who’s on the blocks getting ready to run a sprint in the Olympics, they’re not running wind sprints right before their race. Right? Race time is not the time to practice. So similarly, if you want to do mindfulness, which is a, a great practice for lowering anxiety and, and chronic when dealing with chronic worry. You shouldn’t do it when you’re feeling anxious in response to feeling anxious, you should actually do it on a, on a regular interval. So every morning, whether you’re feeling anxious or not, you do 10 minutes of mindfulness meditation. That’s your practice. You’re building up skills. And there’s a couple of specific skills that help with, with worrying anxiety, with …. with mindfulness in particular. But my bigger point here is you don’t cope with anxiety. You accept anxiety and be willing to have it even though it doesn’t feel uncomfortable and get on with your life anyway. That’s what’s gonna teach your brain long term, that it’s not bad to feel anxious, and that’s gonna make you much, much less anxiety, much less anxious in the long run rather than doing something quickly to make yourself feel anxious, which is gonna give you temporary relief, but it’s gonna make you more anxious in the long run. So, be very careful when you implement techniques and tools and tips and tricks and stuff. Don’t do it to get rid of your anxiety, do them as exercises to build up strength and skill. Right? So that’s my last …. that’s my last tip, and I’m happy to go and we can go more into …. into that as we go on.

Emma: Well, I love, I do, and I love that you said that because I also wanna clarify right at the beginning, I started out with like breathing exercises, but they only work in context with willingness, which is one of the principles of mindfulness, right? This idea of non-striving. You’re not forcing your thoughts to change when you do mindfulness, you’re not forcing your feelings to change. You’re creating a space where you can observe them. Is that correct? Am I pretty, am I accurate?

Nick: Bingo. Yeah.

Emma: Yeah. And so as soon as we try and get like into a battle with anxiety, we give it a ton of power. And when we’re willing to feel it and choose our own actions, then it’s like, eh, it doesn’t have nearly as much of an impact in our lives.

Nick: Yep. I love it. Yeah, well said. All right. We stayed relatively on time. Good job.

Emma: Surprise.

Nick:I was worried that I was gonna totally blow this.

Emma: Me too. Not about you. About …. about myself.

Nick: Yeah. So okay, so let’s there are a ton of questions. Let’s try and go back to the top and see maybe we can each, let’s …. let’s go through the questions and we’ll each like popcorn it, we’ll each just give our quick like reaction to the question. And go on.

Questions and Answers

Potential Solutions and Relief for Morning Anxiety

Emma: Can I answer the first one that I saw

Nick: Totally

Emma: Because I saw that already. Peggy asked, “I have the worst anxiety in the mornings. Is there a clue there that could help me feel better?” This is gonna be a shameless plug, but I made a video on YouTube about morning anxiety and if you look at, so if, you …. you could go Google that like Therapy in a Nutshell morning anxiety and if you look at the circadian rhythm in the morning, your cortisol is gonna spike. That’s cortisol, one of the hormones that’s considered a stress hormone and it’s called the cortisol awakening response. And that’s a common reason why a lot of people feel more anxiety in the morning is cuz of what their body is doing. And some of the things you can do to manage that are like, there are some diet changes you can make that can decrease cortisol like, eating less inflammatory foods, but in general, it’s like choosing some kind of activity to help burn off that cortisol in the morning, like morning exercise might be really helpful. There’s some other options too, and you could check out that video if you want more resources.

Nick: It’s a great video. I would recommend it. I’ve seen it. I would also, I will add something to that. When it comes to morning anxiety, one of the most pragmatic I’ve things I’ve seen to be helpful is to immediately get out of bed. Now, this is easier said than done. It’s hard, but often the best thing you can do is the moment you wake up and if you wake up feeling anxious, just get right out of bed, no matter how you feel, get right out of bed. Because what often happens is you wake up feeling anxious, but then you lay in bed and you try to go back to sleep or you try to relax or whatever it is. And what you end up doing is just worrying. Often you worry about feeling anxious and how what that affects that’s gonna have on during your day. But if you just get right out of bed and get into the shower or go make a cup of coffee or whatever it is, you, you short circuit that …. that worrying process, which keeps your overall anxiety much, much lower. So that’s my quick …. my quick tip on morning anxiety.

Emma: And going back to our principles on it, it’s like this has a function. Like, our bodies are made to pump out a ton of cortisol in the morning to get us moving and to get us going. So, it’s really only when we’re trying to suppress that feeling that we get stuck in these cycles of like, I’m laying in bed trying not to feel this way and like panicking, right?

Managing The Physical Side Of Anxiety

Nick: Totally. Okay, let’s do the next one. Mia said, “How do we manage the physical side of anxiety, especially if we experience it more strongly than the mental aspects.” what do you got? What’s your first hot take on that, Emma?

Emma: Physical side of anxiety? I am a huge fan of two things. The first one I would say as somewhat anxious person is exercise. But that can be like a double-edged sword. Like, if you are constantly running away from your anxiety, that can as an avoidance skill or a coping skill that can actually make anxiety worse. But as like a body mindfulness based, like self-care and a self-compassion skill, like, exercise can help your body burn off some of that tension and some of that cortisol and exercise is a good, you know, well evidenced treatment for anxiety and a really good treatment for depression. So, the first thing I would say is like, use your body for some movement. And then the second thing I would say is willingness. So, willingness is a skill from acceptance and commitment therapy, which is like practicing and training yourself to create openness to your sensations. So you say like, oh, hello, butterflies in my stomach. You are very uncomfortable. And instead of labeling things as bad, that’s another aspect for mindfulness and non-judgmental attitude. So instead of labeling things as being bad, oh, it’s so terrible that my hands are sweaty, it’s so awful that my stomach is upset, you say, “Oh, I’m gonna notice and describe and be curious about what these sensations are, and I’m gonna create space around them.” I’m actually wearing my shirt today. I just got these shirts printed, says, let’s get better at feeling. And it’s this idea like, let’s open ourselves up to having these physical sensations instead of just trying to make them go away, which, like, locks us in a battle with our anxiety, which makes it worse.

Nick: Those are great. This question makes me think of one of my favorite research studies and anxiety looked at the effect of reframing the way you talk about anxiety on your overall experience of anxiety and how much you experienced and what they, that what they did was really, really cool. All they did versus the treatment group versus the control group was they had, they got people anxious and then they said, when you’re feeling anxious, instead of saying, oh, I feel so anxious. Tell yourself, I’m feeling really excited right now.

Emma: Yeah, yeah.

Nick: And what’s really cool about this is that physiologically there’s no difference between anxiety and excitement. Both are emotions. One is quote unquote positive and one is quote unquote negative. But if you were hooked up to an FMRI machine and scanners and skin conductants sensors and all the best physiological measures, no doctor in the world could tell the difference between excitement and anxiety. You get someone really excited and really anxious, everything’s gonna look the same. Your heart rate’s gonna go up, your respiratory rate’s gonna go up, your muscle tension’s gonna go up, your pupils are gonna … All the same stuff because it’s all underneath the hood. It’s all the same thing.

Emma: Yeah.

Nick: It’s all …. it’s all adrenaline, primarily some cortisol and stuff like that, but …. but it’s actually can be a really helpful thing is to say like, I’m …. I’m feeling really excited right now. Right? Which my body is getting revved up for something. It’s uncomfortable, right? But it’s uncomfortable when you get excited for something too, if you really pay attention to those …. those feelings. But they’re the exact same feelings. So, reframing anxiety as excitement can be surprisingly powerful, actually. So, that’s my tip on that one.

Balancing Self-Care and Acceptance

Emma: Yeah, I love it. I love it. Yep. Okay.

Nick: Okay. Let’s see., Leah had something about in the age of self-care, how much acceptance do we need for a condition and where can we expect effort from the affected person? I’m not sure what this is.

Emma: I …. I wonder if …. I wonder if they’re saying like, hey, my son has depression and won’t get out of bed. And in this age, should I be like, oh, you know, let’s be like open and accepting of like the reality that depression is a disorder. Or do I be like, hey, you need to pay your bills or I’m kicking you out of the house. Right? I …. I’m assuming that’s what this question is about. How much effort can we expect from an affected person? Now, when it comes to myself, like personally, like when I’m dealing with my mental health, the stance I take is a growth mindset. It’s just saying, well, what can I learn about this? Let’s explore, let’s keep my mind open instead of labeling myself as being broken and just assuming there’s no room for growth. So, when it comes to myself, I …. I actually have very high standards of like, I’m gonna try a hundred things before I resign myself to anything that I don’t want in my life. That’s kind of my approach. And I encourage my clients when I’m working with them directly to consider lots of options and try lots of things before they decide that they’re just gonna kind of settle for a life that they don’t like that much. But it’s a little different when you’re working with someone else. When you’re working with someone else it’s not always helpful to be like, you should, you should, you should. It just, you have to look at this pragmatically. And it’s often more helpful to focus on connecting with them first before giving advice or setting boundaries instead of like nagging or dragging or convincing or coercing. So like in the example of, you know, son living in the house, you might be more, it …. it might be more effective to just say, “You need to be paying rent or you can’t stay here.” That actually might be an effective approach more effective than saying you should, you should do a job interview. You should do a job interview. You should do a job interview, right? Like the nagging approach. So, like, to really get a lot of clarity about what’s in your control, what isn’t in your control, and then develop the skills to be like good listener, to be understanding. But just because you understand something doesn’t mean you need to allow it as well. So you, I mean, if it’s someone in your life do the locus of control exercise, you make three lines or three sections on a piece of paper. You say, what’s in my area of control? What can I control? What can I influence and what is completely outta my control? I can’t control whether my son gets a job or not. I can’t control whether he’s motivated. I can’t control how he feels. I can control whether I’m listening, empathetic, whether I help him get resources, whether I pay the rent or not, whatever. Right. And you just get really clear on that.

Scheduling Worry Time

Nick: I have nothing to add. That’s a perfect answer in my opinion.

Emma: Okay.

Nick: Really good.

Emma: Wow. Alright.

Nick: That’s great. Yeah. Okay, so another one was, I wake up feeling anxious. , would it be best to do scheduled worry time when I’m calm later in the day or in the morning when worries are popping into my head? So we talked about morning anxiety, waking up, anxious. You could do either. I’ve found that in general, people later in the day worry tends to be a little bit better for this in terms of a long-term habit. But back to Emma, you just made the point. Experimenting is really important. All these things we talk about, they’re gonna be individualized to some degree. And so it’s an important, like, mindset thing here is what I call experimentalism, which is this idea that like you’re gonna need to experiment and adjust things on your own and …. and try out different things to see what works for you. Like, very few things are just gonna be plug and play and work exactly the way they’re described. You’re gonna have to play around with a little more a little bit. So, what I would say is just try both. Do it for a week, do it first thing in the morning and then for another week. Do it in the evening and then see which one seems to work better for you. And that, by the way, that principle applies to a lot of the stuff we’ve talked about, not just that scheduled worry. So that would be my …. my take on that one. I dunno if you have something on that, Emma or if you wanna move on.

Examining the Role of Bottom-Up Approaches

Emma: Nope, that sounds great. And I will answer the next question very quickly. Would …. would the bottom-up approaches of physical relaxation techniques qualify as coping techniques? We did kind of address that. Yes, they absolutely can become a coping technique if they’re used the wrong way. And I will refer you if you …. if you Google, if you go on YouTube and search acceptance as a treatment for anxiety with my name, Therapy in a Nutshell, you’ll find a video I made on how you can kind of lay the foundation of acceptance before you try and use a body-based grounding skill. Like that …. that paradox of acceptance and change is really interesting. So if you search for that video, you’ll find it.

Nick: Yeah, and I would piggyback on that and say that what …. what I often tell myself and clients and people I work with is that it’s not avoidance if you …. if you validate first. So, if you acknowledge the thing and validate that, hey, this, I’m worrying, I don’t like worrying, right? It makes me feel x I feel uncomfortable, but it’s not a bad thing, and I’m not gonna try and get rid of it. I’m gonna let it hang out, and I’m gonna …. I’m gonna get on with whatever it is I was doing.

Emma: Yeah.

Nick: Which maybe …. maybe is a deep breathing exercise. Right? But the point is, if you, first, you gotta attend to the relationship with your anxiety first and say, hey, I’m not afraid of this thing. I don’t like it. Right? But I’m willing to have it and I’m gonna get on with my life now. Right? It doesn’t have to this big hole. You don’t have to have a huge 60-minute therapy session with yourself about why you’re feeling anxious. You can just acknowledge it, validate it, and then be willing to have it and move on with whatever it is you wanna be doing in that moment.

Emma: Mm-hmm. And same thing goes with those physical sensations. You’re like, hello, anxious stomach. Nice to see you’ve joined me today. Thanks for coming. I’m still gonna go give this presentation. Or you say like, oh, hello, anxiety, glad you’re here. You usually show up at the night anyway. Wasn’t surprised. Okay, I’m gonna go back to doing my thing. Right?

Immediate Strategies for Addressing Anxiety Bursts

Nick: Yes.

Emma: You just like, hello, treat it like, it’s called externalizing. Treat it like a person. Give it a name.

Nick: Exactly. Yep. Totally. And actually the, the next question is similar. If mindfulness is best as an exercise, not a coping technique in the moment of an anxiety burst, is there something else that’s better to do in the moment to address the anxiety burst outside of the longer term techniques discussed today? Yeah, so the …. the …. the kind of like Yoda-like zen answer to this question is you don’t have to do anything about anxiety. No matter how bad the anxiety is, the trap, the mental trap is I have to do something about my anxiety. I have to lower it, I have to get rid of it, I have to distract myself from it. All of those things teach your brain that anxiety itself is a threat and make you anxious about being anxious, which in the long run, it’s gonna make you more anxious. So the …. the …. the real trick, and I don’t want this to sound like a non-answer or a cop out, is to be willing to have whatever it is you’re experiencing. Don’t make your actions about your anxiety. Make your actions about the life you wanna live. And …. and after acknowledging it, allow it to come along for the ride. It’s very counterintuitive and it’s not …. it’s not easy. This takes practice, right? It takes commitment. You have to practice and work at this, but that is ultimately the way to deal with those anxiety bursts in the moment. I think.

Emma: I would totally agree. I love that answer and I have to acknowledge Nick and my’s bias. One of the reasons I love Nick is that he and I both do the same thing, which is we actually wanna create sustainable solutions to, like, problems. So I don’t teach a lot of coping skills. I don’t teach people to diagnose themselves. I teach like actionable skills that should in the long run, resolve anxiety. And …. and Nick, you’ll notice in his newsletter a lot, he talks about the maintaining causes of anxiety instead of the initiating cause of anxiety because he and I are both biased toward, like, this is, we actually believe anxiety can be resolved. Like we actually believe that. Whereas I think there are people out there who don’t think you just need to cope with it. But I actually believe in otherwise. And so, that being said, we are biased toward teaching people solutions that in the long run, resolve anxiety. Now, I do think there is a role for coping skills in the short term. When someone’s in a crisis, a coping skill can help get you through it in the moment. So, if someone’s like, I am suicidal, I am going to quit my job, I am going to beat my child. Yes, that is a fine time to use a coping skill in the short term. And then always put as much effort as you can into doing, like learning the maintaining skills that are gonna decrease your anxiety in the long run. So that requires you to pay attention to your emotions when they aren’t enormous and to do the work and to be consistent. Right? But I do think there’s a role for coping skills in like short-term crises, but that’s about it. Coping skills aren’t gonna be a long-term solution. But if you Google like, what do I do about anxiety? The answers are like, try some coping skills and see a therapist. It’s like, that’s not a lot of help for people who can’t afford therapy whatever.

Nick: Yeah, no, I like that nuance. I …. I think that that is important to acknowledge in our own kind of blind spots and biases with these. I will though say, I think almost always you can still acknowledge and validate the anxiety and then cope. Like it literally takes three seconds to say, hello, anxiety, I know you’re not bad, but it’s really uncomfortable and now I’m gonna go do deep breathing so that I can relax and not do something that’s contrary to my values or that I don’t want to do. Or so maybe it’s more about kind of pairing that …. that mindset of acceptance and willingness with then a coping strategy that’s not, that’s designed to toward something bigger, some bigger value.

Emma: Yeah, a long-term solution. Love it.

Nick: Okay. Someone said I’m gonna, the scheduling worry work with people who tend toward obsessive thinking. I, so it …. it …. it’s a hard question to answer specifically. I have seen it work with people who …. who tend to have obsessive thinking, which is just another, really, another word for you have a lot of intrusive thoughts. So, I think it can be pretty effective. And actually it was designed initially for generalized anxiety disorder, which is, it’s different than obsessive compulsive disorder, but it’s actually similar in that it’s characterized by a lot of intrusive worries. It’s bombarded by worries constantly, right? So, yes, I think it can work really effectively in those situations. The next one, connections between chronic pain and anxiety and worry about coping. Emma, do you wanna, do you have any thoughts on that? Chronic pain is definitely not one of my specialties, but I don’t know if you have more insight on that.

The Connection Between Chronic Pain And Anxiety And Worry About coping

Emma: So, I’ve interviewed a couple experts on this. I’m also not an expert in chronic pain, and there are two aspects of pain. There are physical causes of pain, and pain is a physical condition. And so, when I have my bias toward like the mental aspects of things, and sometimes I talk about the mental aspects of chronic pain, sometimes people feel invalidated that I’m saying like, oh, it’s all in your head. It’s not all in your head. Right. Let’s just, I’ll just say that. And pain can be interpreted by the brain as a threat. So, usually pain is a messenger. It says, hey, you sprained your ankle, you shouldn’t be walking on it. But chronic pain sometimes happens when those messages get mixed up. So, your ankle is healed, but your brain is still adapting to that past injury and still sending those messages. And when we respond to those pain messages with fear, anxiety, resistance, or trying to force them to go away when we’re trying to stuff them, that sends a message to our brain that these pain signals are really important and the things we pay more attention to the brain creates more wiring around and makes louder. So, there’s a very similar approach to the mental aspect of chronic pain, which is, I’m gonna notice, I’m gonna acknowledge, I’m going to accept, I’m going to calm my body. And that can actually decrease that cycle that makes chronic pain worse. So, the mental aspect of chronic pain and our stance or our relationship toward chronic pain can be benefited from treating it similar to anxiety and saying, you know, I’m gonna notice, I’m gonna acknowledge I’m not gonna struggle. I’m gonna allow it to be there and I’m gonna soothe myself and I’m gonna focus on what I want my life to be about.

Nick: Yeah. I love something I wanna point out too, that you alluded to that, and that is so much of what we talked about today, you can see from the perspective of asking yourself the question, what’s gonna be, what’s gonna feel good in the short term and what’s gonna make me feel good in the long term? Like, analyzing things through this short-term versus long-term lens, I think is really, really helpful because if you think about in …. in just about any area of life, there’s so many things that are good for us long term that are hard or difficult in the short term, right? If you wanna learn how to play the piano, right? You have to practice scales and notes and it’s awkward and you feel like you’re not making progress and it’s uncomfortable. And, but like, that’s how everybody learns the piano, right? You go through the uncomfortable stuff in the beginning and then it becomes easier and more natural and fluid as, and you can think about every area of life that’s basically true, any kind of skill. And so I think, an important kind of meta lesson here is that so much of emotional health and wellbeing follows that same pattern. Things that feel really good in the short-term are often unhelpful in the long-term, but things that feel uncomfortable in the short-term often lead to growth and feeling better in the …. in the long run. So that, I think that, I don’t know, I …. I …. I just wanted to like pull out that thread cause I think we’ve both been like, circling on it in a lot of our answers. And it’s a really powerful way to look at and help yourself make good decisions in the moment when you’re struggling with something is to kind of ask that …. ask that question about short-term versus long-term benefits.

Excitement And Anxiety

Emma: Totally. Yep. And speaking of that, will you look for the next question? I’ll address one of these further down really quickly. Someone asked if excitement and anxiety look the same, why does anxiety cause health related issues but excitement wouldn’t probably. They both can if they’re chronic. So, the chronic stress response is harmful and the short-term stress response is totally healthy. So if you’re chronically excited and chronically in that activated nervous system state, that can wear down your heart and cause the exact same symptoms. So it’s …. it’s the same stress response.

Nick: Bingo. I would’ve given the exact same answer like this.

Emma: Yes. All right.

Nick: That’s exactly right.

Emma: Will you pick one that you wanna answer?

Nick: We’re at the top of the hour, Emma. How are you on time?

Emma: I’m okay for another 15 minutes or something if you want.

Nick: Yeah, I could go for another 15 too. You wanna do that?

Emma: Yeah, let’s go. This is fun. I like this.

Navigating Anxiety When Discussing Past Trauma

Nick: I love it too. Okay. Actually, do you want to, this next one, maybe I’ll let you take the first stab at, cuz you do more trauma stuff than I do, but I have anxiety whenever I try to talk to my past, whenever I try to talk about my past trauma with my psychologist. You have any tips on how to not be so anxious talking about it.

Emma: Oh, I have so many thoughts on this one. It’s such a good one. Okay. How do I organize all my thoughts? The first thing is there are treatment approaches to trauma that don’t focus on talking about the past. So, I would consider or recommend that you consider choosing a therapist who practices EMDR or somatic experiencing, because somatic experiencing is gonna focus on helping you regulate that nervous system response first before addressing the thoughts and memories of trauma. Or EMDR is gonna focus on building resources that help you soothe your nervous system and reprocess those memories without necessarily needing to do the talk therapy approach. Talk therapy approach has been validated as an effective approach to PTSD, but there are other methods as well. So, that’s the first thing I would say is you could consider working with a provider who provides a different form of treatment and then coming back to your therapist for the cognitive work. The second thing I would say is that, so this is called a window of tolerance in …. in trauma work, right? Your window of tolerance is the zone where you are actively engaged in. your life and in your emotions, you’re able to be in touch with them. And if you get too stressed out, you go into kind of the panic mode, you get overwhelmed. And if you get too overwhelmed, you go into hypo arousal, the low arousal state, which is you freeze up, you shut down, you lock up. And so the goal with trauma therapy is to stay in that window of tolerance where you’re able to feel your emotions and work through them, talk through your emotions and …. and your memories, and re kind of rebox them up into healthier ways. If you are getting too hyper aroused, too overactivated in your nerve, too stressed out, when you’re talking about trauma, that can re-traumatize you. So, it makes that memory feel sharper every time you retrieve it. Then some of the ways that you can minimize that, I mean, there’s so much I can talk about with this. I love this topic and I’m …. I’m gonna make a whole course on it. But you can decrease the duration of what you talk about. So, you could address trauma for two minutes in a session at a time. You could make it less intense by, instead of talking about it, writing about it, that slows you down. You could add in resources. So, add in something really calming, like a super warm weighted blanket and a cup of tea, I don’t know. But you add in these calming resources to increase your capacity to address the anxiety. And then the last thing I would say is accepting that anxiety is being okay while you do the work is also helpful. But again, like, as someone who works with a lot of trauma, you don’t necessarily want to just re-traumatize and re-traumatize and re-traumatize like that kind of used to be the older way of doing trauma therapy was CBT was like, we are gonna talk about this until we do so much exposure on it that it’s boring for you. And they found that for some people, that that creates a negative cycle. So, it’s normal to feel anxious about talking about trauma. That’s normal and it’s acceptable, but there are things we can do to fit it into your window of tolerance. And I mean, we could talk about that for a long time. But that’s my first thoughts.

Nick: I love it, Emma. Yeah, I would double click on that like. I love the idea of only spending a certain amount of time in a therapy session on a, I used to do this, I didn’t treat a lot of trauma, but I did a lot of phobias. So I …. I would have people come in and they’d have a spider phobia, but the idea of spending 60 minutes talking about spiders was just like, way too much. And they would, they started missing sessions and they just all, because it was just, it was way too much. So, this was like miraculous when I started doing this in my practice, is I’d say like, all right, we’re gonna spend the first 10 minutes, maybe five minutes working on the spider stuff, right? And we’re gonna do it at a very slow pace, and we’re gonna get even smaller. And then we’re gonna spend the other 40 minutes on some other topic you wanna work on. Maybe you wanna work on setting better boundaries or whatever it is. And so, and then so that …. that’s a really powerful thing to …. to discuss with your therapist or counselor, I think is, is doing something like that. But the other thing I would say that, that can help with this, and I think this is another point that generalizes to almost everything we’ve talked about, is it’s very, when you’re struggling with anxiety, it’s very easy to frame the whole project as, how do I lower my anxiety? How do I get rid of my anxiety? And in fact, like we framed this whole …. we framed this …. this workshop on that, like, premise. But actually, I think a better way, usually a better way to frame this problem is not how do I lower my anxiety, but instead how do I raise my confidence?

Emma: Yeah.

Nick: How do I increase my ability to have anxiety and tolerate it and get on with the things that matter to me despite that anxiety? And so you’re, instead of looking at like, did my anxiety go down by another 5% this week or that, look at how much did I increase my confidence for doing things when I’m anxious anyway? And that’s often a much more productive and ultimately like empowering way of looking at being a less anxious person overall. I think it’s a …. it’s a, in some ways it’s an easier way to …. to kind of get there. So, that’s a thought to just sort of keep in mind that kind of confidence mindset versus anxiety mindset

Emma: And the confidence mindset is more likely to lead you to living the life you value instead of living a life that shrinks. So, even if you still feel anxiety, you’ll be living a better life anyway.

Nick: Right, right.

Emma: Isn’t that like the bottom line of acceptance of commitment therapy? Even if it doesn’t work, you’ll still have a good life? Not quite, it’s not quite that.

Overcoming Overwhelming Anxiety

Nick: But that’s …. that’s not a …. not a bad summary, I think. Yeah. Alright. The next …. next question about scheduled worry, I think this is the experiment thing. I experiment with a little bit. If it’s not working for you, do it at a different time.

Emma: The next question says, what if I feel too anxious to actually address the issue? Like, I’m too overwhelmed and I’m unable to make decisions. And I …. I would say, well, I’m not trying to shamelessly plug my channel. I just made two videos about decision-making and they’re on my channel. But there’s two aspects of decision-making that interfere with our ability to make decisions. The first one is emotion regulation. Like, oh, I’m too scared of the outcome that I’m not willing to make this decision. And the second aspect is executive function. So if you’re having a really hard time organizing your thoughts, you’ve gotta support and scaffold your executive function, which for me looks like making things visual and making things concrete, and writing them down and slowing them down and managing small chunks at a time. What do you think, Nick? I just talked right over you.

Nick: I was gonna say chunking like that. That is honestly my, like break it down into smaller, often, like insanely small pieces that are so small, they seem ridiculous. Like, I’m not …. I’m not gonna write down the 10 things I need to do today. I’m not even gonna write down the one thing that I need to do today. My only task is I’m going to write out, I’m gonna say to-do list on top of my page, and I’m just gonna leave that piece of paper there. Like, it sounds insane to do something so small, but breaking things down into smaller pieces than you think is …. is so powerful. Like really, really helpful. So yeah, I would just double click on that one.

Resource for Willingness?

Emma: I’m seeing a couple questions in the chat bar about where can I find resources for these things? And someone asked, where can I find a resource for willingness? And I would just say, the book, Get Out Of Your Mind and Into Your Life, is kind of one of the popular ones. I really like it for learning Acceptance and Commitment Therapy and then also my course, How to Process your Emotions, the whole thing I put on YouTube and there’s like five videos on willingness in that course. So there’s some …. some resources for people asking about that. Yeah.

Nick: Yep. Sorry. And I, no, I think, I think that’s great and your course on that is really good. You and I also have an old podcast from a while ago when we talked about emotional processing which is we talk about willingness a lot. The other thing I would say is, while there are really great treatments and techniques and tips like stuff we’ve been talking about, another way to think about this is if …. if you wanna get better at …. at being willing to have emotions, you’re probably thinking in context of when I get super anxious, how can I get better at being willing to be anxious in those big moments when it’s really hard? And that is the goal, that’s what you wanna work up to, right? But in order to work up to that, it helps to practice on a much smaller scale and maybe even with different emotions. So, if you really struggle with anxiety, maybe the first step to getting better at being willing to have anxiety is to practice being willing to feel frustrated without doing anything about it, or being willing to feel a little bit sad without immediately doing anything about it, right? Or being, think about situations where you just get very mildly nervous or anxious, so mild that you normally just like wouldn’t even do much about it. Use that as a practice opportunity to say, “Okay, I’m feeling a little bit nervous. It’s uncomfortable, I don’t love it, but I’m gonna be, I’m gonna get on with what I’m doing and I’m willing to continue to feel a little bit nervous.” And as you get good at doing the 2% version of that, right? You can do the 4% version and if you can do the 4%, you can do the 6% and eventually you will get up to the 80% version or the 90% version. So again, this is the bigger principle here, I think is a lot of this stuff, these skills we think about in emotional health, they’re just like skills in any other aspect of life, whether it’s learning algebra or the piano or speaking French or whatever it is, start small. Give yourself patience to work up to the big stuff.

Effectiveness of EMDR

Emma: Totally, totally. Hey, I have a quick answer to one of these questions while you look at the next one. Is that okay?

Nick: Great. Do it. Yep.

Emma: Someone asked, does the EMDR work with just a single event or does it work well with long sustained, painful events. And research shows that it’s more effective with single event trauma than with complex PTSD, but it is still effective for complex PTSD. That’s an easy answer.

Nick: Gotcha. Yep. John asked, is there a possibility to meditate for sustainable happiness deep within like a home-based to interact with the world around us? Separate with connected flow with emotions and thoughts, but not be. Yeah, so this question, when I talk about using meditation or mindfulness for, to kind of help with anxiety, that is one particular way you can use mindfulness, right? But mindfulness is useful for all sorts of things. For some people it’s a spiritual practice, right? For other people it’s a …. it’s a relaxation practice. For other people, it’s about fostering happiness and inner peace. And there’s a million in one ways, and I’m not discounting any of those, like those are all very useful and there’s experts who talk about all those things. But if you do want to utilize mindfulness as a practice in order to kind of lower your overall anxiety, there is a very particular way to do it, which …. which we talked about, which is mostly don’t use it as a coping skill, use it as an exercise. Right? But that distinction about the uses of mindfulness is important. It’s …. it’s a huge topic and a huge practice that’s useful for all sorts of things. And …. and we’re just focusing on a tiny slice of version of it. Let’s see. Emma, do you have another one?

Blushing When Speaking In Public

Emma: Hmm. There’s a lot of like, big questions in here that I hesitate to open up because they’re like, great questions, but we don’t have time for. There’s a …. a question in here about blushing when speaking in public, even in really small groups. This is a really common symptom with social anxiety, not just, not the blushing so much as the worrying about blushing, though blushing can be an anxiety response. And I would say, drop the struggle with blushing and say, I’m gonna choose to engage and interact with these people anyway. I would say like …. like trying to make yourself not blush is gonna backfire. That’s what I’d say to that. And I I enjoy helping people. I love doing therapy one-on-one. I get pretty nervous about doing public speaking. And I just have to say like, my hands, sometimes my voice will shake. Sometimes I’ll, my hands will be shaky, I’ll be upset in my stomach or whatever, and I just have to say, you know what? I value doing this work more than I value avoiding this feeling and I choose to engage anyway. That’s my advice on that. I don’t know if you have any more to add.

Nick: You know, well, I, just to clarify that I, there’s, there’s actually a lot of research on this phenomena, like physical symptoms of anxiety before performing, whether that’s talking in a meeting at work or performing a huge musical concert or something, and they’ve looked at, they’ve compared expert performers, like, think like rock stars or Tony Robbins or people who literally every day for a living get up in front of people and …. and talk and present. And they compare those to people who are like novices or rookies who feel very, very anxious. And what’s really fascinating is, and there’s all, there’s sophisticated way they’ve done this, but their …. their level of physical arousal is not that different. Tony Robbins gets butterflies, right? He …. he …. he blushes. I don’t know what the specifics are, but like what differentiates expert, confident public speakers is not the lack of physical arousal, it’s their relationship with their physical arousal. And to Emma’s point, they don’t catastrophize it. They don’t worry about it. They actually just don’t spend that much time at all. They probably briefly say like, hey, here it goes again. Like, this happens every time. I’m reframe it. I’m getting excited. I’m getting pumped up. Right? And it’s normal. And so I think that gives some support to evidence for what you were saying, which is, it was kind of mind blowing when I heard that. Like that’s, it’s pretty wild, but cool.

Emma: I love it. I, yeah, I think people with social anxiety assume that everyone else isn’t feeling social anxiety, that they’re the only one who is. And I think a lot of very socially connected and outgoing people are also feeling those emotions, but they just don’t give ’em that much importance and they don’t struggle with them. They don’t struggle with them. I don’t mean they don’t struggle with them, like, they don’t experience them. I mean, they don’t fight them. They don’t get on, hold that rope and like yank and try and make it stop and like try and force their feelings to go away. They just focus on what they wanna be doing.

Nick: Well, I think that’s a good place to …. to wrap things up, and I …. I appreciate you being willing to go over time a little bit and answer more questions.

Emma: Yeah. It was fun.

Nick: But yeah, thank you Emma, for …. for being willing to do this and come on and share all your insights and wisdom and …. and tips and thank you all …. all of you for attending and your great comments and questions and support. We really appreciate it. I hope it’s been, hope it’s been helpful.

Emma: Thank you so much for having me. And thanks everyone who came. That’s really fun.

Nick: All right.

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